<%-- 
    Document   : form
    Created on : Jun 18, 2011, 3:30:51 PM
    Author     : Whilda
--%>

<%@page contentType="text/html" pageEncoding="UTF-8"%>
<%@taglib uri="http://java.sun.com/jsp/jstl/core" prefix="c" %>
<!DOCTYPE html>
<html>
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
        <title>JSP Page</title>        
    </head>
    <body>
        <c:url value="/pasien?action=update" var="update"/>
        
            <form method="post" action="${update}">
                <table align="center">
                    <tr>
                        <td align="center" style="font-size:20" colspan="3">FORMULIR PENDAFTARAN DONOR DARAH PMI</td>
                    </tr>
                    <tr>
                        <td>Tanggal</td>
                        <td>:</td>
                        <td><input type="text" name="tanggal" size="30" value="${pasien.tanggal}"></td>
                    </tr>
                    <tr>
                        <td>ID</td>
                        <td>:</td>
                        <td><input type="text" name="id" size="30" value="${pasien.id}"></td>
                    </tr>
                    <tr>
                        <td>Nama</td>
                        <td>:</td>
                        <td><input type="text" name="nama" size="30" value="${pasien.nama}"></td>
                    </tr>
                    <tr>
                        <td>Alamat</td>
                        <td>:</td>
                        <td><input type="text" name="alamat" size="30" value="${pasien.alamat}"></td>
                    </tr>
                    <tr>
                        <td>No Telp</td>
                        <td>:</td>
                        <td><input type="text" name="telp" size="30" value="${pasien.telp}"></td>
                    </tr>
                    <tr>
                        <td>Umur</td>
                        <td>:</td>
                        <td><input type="text" name="umur" size="30" value="${pasien.umur}"></td>
                    </tr>
                    <tr>
                        <td>Golongan Darah</td>
                        <td>:</td>
                        <td><select name="gol">
                                <option value="O">O
                                <option value="A">A
                                <option value="B">B
                                <option value="AB">AB
                            </select>
                        </td>
                    </tr>
                    <tr>
                        <td>Jenis Kelamin</td>
                        <td>:</td>
                        <td><input type="radio" name="kelamin" value="pria" size="10" >Pria<input type="radio" name="kelamin" value="wanita" size="10" >Wanita</td>
                        <%--mas ini yang jenis kelamin, py carane yen pas klik update, radio button nya juga ikut terisi sesuai yang ada di database
                        kalau yang lainya sih udah, yang belum cuman radio button sama comboboxnya--%>
                    </tr>
                    <tr>
                        <td>Berat Badan</td>
                        <td>:</td>
                        <td><input type="text" name="berat" size="30" value="${pasien.berat}"></td>
                    </tr>
                    <tr>
                        <td>Tinggi Badan</td>
                        <td>:</td>
                        <td><input type="text" name="tinggi" size="30" value="${pasien.tinggi}"></td>
                    </tr>
                    <tr>
                        <td>Keterangan</td>
                        <td>:</td>
                        <td><input type="text" name="keterangan" size="30" value="${pasien.keterangan}"></textarea></td>
                    </tr>
                    <tr>
                        <td><input type="submit" value="update"></td><td><input type="reset" name="reset"></td>
                    </tr>
                </table>
            </form>
        
    </body>
</html>